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NPI Code Detail

MEDICARE: DAWN LEWIS R.N.

MEDICARE: DAWN LEWIS R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN042597AZ

General Provider Information

NPI Number : 1003129354
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN LEWIS R.N.
Provider Business Mailing Address
First Line : 105 N 5TH AVE
Second Line :
City : HOLBROOK
State : AZ
Zip : 86025-2817
Country : US
Telephone Number : 928-524-6701
Fax Number : 928-524-3068
Provider Business Practice Location Address
First Line : 105 N 5TH AVE
Second Line :
City : HOLBROOK
State : AZ
Zip : 86025-2817
Country : US
Telephone Number : 928-524-6701
Fax Number : 928-524-3068
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2010
Last Update Date : 07/15/2010

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